NURS FPX 6011 Assessment 2 Evidence-Based Population Health Improvement Plan

Name

Capella university

NURS-FPX 6011 Evidence-Based Practice for Patient-Centered Care and Population Health

Prof. Name

Date

Evidence-Based Population Health Improvement Plan

Greetings to all, and thank you for being here today. My name is Lupi. I am presenting a population health improvement plan to address the pressing issue of hypertension in the rural communities of West Virginia (WV). Hypertension is a condition of persistently high blood pressure, often exceeding 140/90 mmHg. It increases the risk of cardiovascular disease, stroke, and kidney damage (Chang et al., 2022). Today, we will explore the data and strategies to address this problem at the community level. This plan emphasizes important factors contributing to the problem, including inadequate technology facilities, healthcare access, unhealthy lifestyle habits and cultural impacts that delay early detection and reliable treatment. Through targeted interventions, we can significantly impact the health of our rural communities.

Community Data Evaluation

Environmental and Epidemiological Data

Information	Epidemiological Data	Source of Evidence	Validity and Reliability
Adult worldwide population affected by hypertension	1.28 billion	(WHO, 2023)	High validity and reliability
Hypertension statistics in the communities of WV	43.4% overall population and 17.1% female are hypertensive.	(America Health Rankings, 2024)	High validity and reliability
Contributing Factors	Limited healthcare access, unhealthy lifestyle habits, physical inactivity and family history deteriorate the disease.	(Chang et al., 2022).	High validity and reliability
The annual economic burden of hypertension on the US	$79 billion	(CDC, 2024)	High authority and reliability
Education levels in WV	500,120 West Virginians aged 25+ had a high school diploma, and 210,631 had some college but no degree.	(Statista, 2023)	National survey, regularly updated
Annual costs of hypertension management	$130–$200 billion	(CDC,2022)	High authority and reliability

NURS FPX 6011 Assessment 2 Evidence-Based Population Health Improvement Plan

WV is home to a varied population. According to the World Health Organization, about 1.28 billion adults are impacted by hypertension (WHO, 2023). In WV, around 43.4% of the overall population is affected by hypertension. More than 17.1 % of West Virginian women are hypertensive (America Health Rankings, 2024). The epidemiological figure suggests that hypertension is a significant health concern in WV. Major contributing factors to this disorder include limited access to healthcare, poor technology knowledge, unhealthy lifestyle habits, physical inactivity, and family history (Chang et al., 2022).

Moreover, the Centers for Disease Control and Prevention (CDC), reported that the economic burden of hypertension on healthcare in the United States (U.S) is substantial, estimated at $79 billion annually (CDC, 2024). Considering the broader costs associated with hypertension management, this figure can range from $130 billion to $200 billion annually (CDC, 2022). In WV, educational attainment impacts health outcomes, as 500,120 residents aged 25 and older hold a high school diploma, and 210,631 have some college experience without earning a degree (Statista, 2023). Addressing these interconnected issues is crucial for improving public health and alleviating the widespread impact of hypertension.

NURS FPX 6011 Assessment 2 Evidence-Based Population Health Improvement Plan

Environmental factors play a crucial role in the high rates of hypertension in rural communities of WV. One significant issue is limited healthcare access, as many low-income areas face substantial obstacles in obtaining essential medical services and preventive care. This restriction contributes to elevated hypertension rates, as residents do not have consistent access to blood pressure monitoring, affordable medications and guidance on lifestyle modifications (Thrift et al., 2020). Additionally, inadequate technology facilities and knowledge delay appropriate hypertension management. Physical activity levels in these areas are hindered by a lack of fitness facilities and safe, accessible spaces due to geographic isolation and insufficient infrastructure.

Financial constraints exacerbate this issue by preventing many from affording gym memberships and reliable transportation to fitness centers. Moreover, socioeconomic status is also a significant factor, with hypertension being more prevalent in WV communities with lower income and education levels (Abrahamowicz et al., 2023). Limited educational attainment is associated with poorer health literacy, diminishing persons’ ability to make well-informed diet and physical activity decisions (Thrift et al., 2020). Finally, rural areas in WV face disparities in healthcare access, creating barriers to preventive care and effective treatment for hypertension. This unequal distribution of resources leads to cases of undiagnosed and unmanaged hypertension, perpetuating a cycle of adverse health effects.

Meeting Community Needs

Hypertension represents a major public health issue in rural WV communities, affecting low-income groups and minorities. This health improvement approach outlines the ethical interventions to reduce hypertension rates by addressing the prevailing environmental certainties, cultural barriers and health disparities in rural populations.

Goals of the Health Improvement Plan

1. Lower Hypertension Prevalence: The incidence of hypertension among adults will reduce by 15% within five years.
2. Enhance Technology-Driven Healthy Living: Expand access to telehealth platforms and mobile apps that offer tools for diet modifications, medication tracking and personalized exercise plans by 10%.
3. Advance Cultural Competency: Enhance culturally sensitive health education to address hypertension awareness and misconceptions within WV rural communities.
4. Expand Preventive Care Access: Increase routine preventive healthcare appointments like regular blood pressure screenings and medication adherence by 15%.

Rural communities in WV face significant socioeconomic challenges that complicate efforts to manage hypertension. The strategy will take into account various environmental factors. Low-income areas are classified as food swamps with limited access to fresh and balanced food. The limited availability of safe recreational areas like parks restricts opportunities for consistent physical activity. Disparities in healthcare access, especially for preventive services impede the early identification and management of hypertension in certain communities. Cultural norms related to technology use, diet and lifestyle influence food choices, physical activity and treatment adherence, contributing to different hypertension risks and health outcomes.

Interventions to Meet Community Needs

Several evidence-based approaches exist to address hypertension and promote healthier lifestyles. Community-based education programs on technology integration and nutrition education in the workplace and community centers, especially in the rural regions of WV, are effective approaches. These programs should incorporate telehealth services and mobile apps for regular blood pressure monitoring, virtual consultations, and Dietary Approaches to Stop Hypertension (DASH) diet, encouraging diverse populations (Chang et al., 2022). Moreover, healthcare providers, technology companies, and community organizations must collaborate to manage hypertension in rural settings.

Coordinated efforts in developing accessible mobile applications that are easy to use can provide personalized, actionable solutions for the underserved. Engaging at critical points in the workplace and home supportive network can be fostered to promote lifestyle changes and health literacy (Chang et al., 2022). Local community programs can be used to increase remote access to healthcare for low-income families, managing hypertension through telehealth services and mobile health applications. These programs support regular remote blood pressure tracking, virtual consultations, and lifestyle modification support.

NURS FPX 6011 Assessment 2 Evidence-Based Population Health Improvement Plan

Rural development strategies should adopt telehealth platforms in the management of hypertension. Telehealth and mobile applications enable remote monitoring and appropriate health education tailored to rural communities’ WV challenges (Chen et al., 2020). Awareness about hypertension risks and management can be effectively promoted through culturally sensitive health education programs by respected community members and role models (Abrahamowicz et al., 2023). Increasing access to preventive care could be achieved through complimentary or low-cost screenings for blood pressure and cholesterol at community gatherings. Embedding hypertension prevention strategies into routine health services within local clinics ensures that hypertension-related conditions are identified and treated promptly. It reduces the burden on the healthcare system and improves the general community’s health outcomes.

There are numerous obstacles to executing telehealth programs for hypertension management in rural communities in WV. Among the significant challenges is that inadequate broadband infrastructure and lack of internet access limit the utilization of telehealth systems and mobile applications. Low-income families cannot afford equipment or data plans to make these services accessible. In addition, rural communities need more technological skills and experience in digital tools, which tends to decrease their use of telehealth services. Moreover, cultural and linguistic barriers increase program failure (Chen et al., 2020). Consequently, there needs to be more awareness of its associated risks, and participation in prevention is reduced. Moreover, non-English-speaking populations are worse off because the lack of health education materials and provision of services in a different language hinder their participation. Last, poor economic capacity makes low-income families select unhealthy food instead of more expensive and healthier food.

NURS FPX 6011 Assessment 2 Evidence-Based Population Health Improvement Plan

Healthcare providers and community program staff should be trained in integrating technology education to manage hypertension. Expanding broadband infrastructure in rural areas can improve internet connectivity and enhance telehealth services. Offering low-income families discounted and free devices. Technical support can improve their digital literacy. It will also make digital platforms user-friendly, multilingual, and easy to navigate for the improvement of accessibility.

Collaboration with government agencies and private sector partners helps fund and promote telehealth initiatives while training healthcare personnel to deliver effective virtual care (Chang et al., 2022). Education on cultural competency improves communication and ensures long-term success in understanding cultural perceptions of hypertension. Moreover, translating public health materials and programs into multiple languages will enable non-English-speaking residents to access and comprehend essential information. Financial incentives for buying nutritious foods help poor families overcome the cost barriers associated with healthier diets (Abrahamowicz et al., 2023).

Outcome Criteria for Evaluating Success

Several key benchmarks will be used to assess the success of the hypertension health improvement plan. The most critical objective is achieving a 15% reduction in hypertension rates among adults within five years. It demonstrates the plan’s lifestyle adjustments and behavioral changes promoted through the plan work. Another metric will be the greater adoption of telehealth technologies, including mobile applications. It aims to offer training on telehealth device use and remote diet management, medication adherence, and tailored exercise prescriptions, with a target level of 10%. Community outreach will be measured by setting the objective of a 20% rise in participation in nutrition and physical activity programs at local levels over two years.

This will demonstrate that these programs are accessible, effective, and culturally tailored to meet community needs. Moreover, enhancing access to healthy food choices is also important, and the goal is to reduce food deserts in rural WV by 20% over five years and improve access to affordable and healthy food. This will address environmental challenges to nutritious eating and provide measurable progress. In addition, an increase of 15% in the usage of preventive care, such as blood pressure checks, in two years will be made to diagnose cases early and enhance health in the long run. A rise of 15% in knowledge regarding the risks of hypertension and healthy lifestyles among various populations will be measured two years after implementing specific educational programs for diverse groups. This epitomizes the success of combining telehealth and culturally sensitive education to defeat barriers and attain better health outcomes within the community.

Communication Plan

Effective engagement with information technology, community stakeholders and residents is important for the success of the hypertension health improvement initiative in rural WV. Communication strategies must be ethical and culturally aware to ensure that information gets to all community members irrespective of language, education and physical abilities. Integrating telehealth and mobile apps, supported by technology providers and healthcare systems makes it easier for rural residents. Health data, remote consultations and personalized care plans are easily accessible.

The key stakeholders in this process are local government bodies, public health officials, policymakers, and rural development planners overseeing health and technology infrastructure projects (Chen et al., 2020). Healthcare institutions, including hospitals, clinics, and medical professionals, will be key in providing screenings, educational outreach, and treatment of hypertension. Moreover, community-based programs targeting nutrition and physical activity in low-income areas will benefit from the involvement of local businesses, including food banks, to support access to healthy foods. Lastly, rural area residents and their families affected significantly by hypertension must be engaging partners as they are the stakeholders of these health interventions (Chen et al., 2020).

Ethical and Culturally Sensitive Communication Strategy

During the implementation of the health improvement plan, all collected health data, including remote blood pressure readings and visit records, will be managed in compliance with privacy regulations, including the Health Insurance Portability and Accountability Act (HIPAA). Personal health information confidentiality will be a major concern in developing and maintaining participant trust (Hodge et al., 2022). Before participating in telehealth activities, screenings, and data collection, participants will be provided with clear, accessible information about the program’s purpose. Consent forms will be available in multiple languages and accessible formats to meet the needs of rural communities in WV.

Considering the linguistic diversity of WV, all the health education materials, presentations, and campaign content will be interpreted in the main languages spoken within the region. Moreover, qualified interpreters will be present at in-person events to facilitate real-time interpretation. Communication strategies will be tailored to reflect the cultural perspectives of various ethnic groups on health, nutrition, and routine blood pressure monitoring. Information will be disseminated in diversified forms like infographics, posters, simplified written content, subtitled videos, and audio recordings (Hasanica et al., 2020). These resources are made to support different levels of health literacy and accommodate the disability of individuals, either visually or audibly challenged. Additionally, the medical jargon and mobile app use will be simplified and presented in plain language, which will be understandable to everyone in the community.

Evidence Supporting Interventions

Evidence-based interventions with peer-reviewed research are necessary to manage hypertension and improve health outcomes. Studies leading to our rural WV community health improvement plan will be relevant and useful in managing local health problems. Chang et al. (2022), explore that telehealth and mobile apps can provide individualized nutrition and exercise programs that enhance healthy lifestyles in rural regions. However, there are different opinions regarding implementing these programs, especially regarding the difficulty of reaching minority populations based on the issues of technology, health literacy, language, and cultural diversity.

In addition, Abrahamowicz et al. (2023), emphasize that access to healthcare facilities should be increased, which is especially crucial for WV communities regarding economic status. However, some scholars believe that focusing purely on access to healthcare overlooks the role of social determinants, such as income disparity, which influence treatment. However, Chen et al. (2020), raise valid concerns about the practical challenges of making and implementing such campaigns, especially regarding the time and financial resources they entail. By integrating such insights, we have developed a telehealth-based and culturally sensitive approach to address hypertension in rural communities in WV.

Conclusion

Addressing hypertension in rural WV requires a comprehensive approach that improves access to care, boosts health education, and engages the community. Expanding telehealth services, promoting preventive care, and ensuring culturally tailored programs can effectively reduce hypertension rates. Collaboration among healthcare providers, community organizations, and local stakeholders is essential for creating sustainable health improvements and fostering trust within these communities.

References

Abrahamowicz, A. A., Ebinger, J., Whelton, S. P., Mensah, Y. C., & Yang, E. (2023). Racial and ethnic disparities in hypertension: Barriers and opportunities to improve blood pressure control. Current Cardiology Reports, 25(1), 17–27. https://doi.org/10.1007/s11886-022-01826-x

America Health Rankings. (2024). Explore High Blood Pressure in West Virginia | AHR. America’s Health Rankings. 

https://www.americashealthrankings.org/explore/measures/Hypertension/WV

CDC. (2022, October 3). Health topics – High blood pressure. https://www.cdc.gov/policy/polaris/healthtopics/highbloodpressure/index.html 

CDC. (2024, May 8). Health and Economic Benefits of High Blood Pressure Interventions. National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP). https://www.cdc.gov/nccdphp/priorities/high-blood-pressure.html

Chang, A. R., Gummo, L., Yule, C., Bonaparte, H., Collins, C., Naylor, A., Appel, L. J., Juraschek, S. P., & Davis, L. (2022). Effects of a dietitian‐led, telehealth lifestyle intervention on blood pressure: Results of a randomized, controlled trial. Journal of the American Heart Association, 11(19). https://doi.org/10.1161/jaha.122.027213

NURS FPX 6011 Assessment 2 Evidence-Based Population Health Improvement Plan

Chen, N., Spigarelli, F., & Lv, P. (2020). Stakeholder power analysis for telehealth solution implementation in China, facilitators, and barriers. JMIR Formative Research, 6(1). https://doi.org/10.2196/19448

Hasanica, N., Catak, A., Mujezinovic, A., Begagic, S., Galijasevic, K., & Oruc, M. (2020). The effectiveness of leaflets and posters as a health education method. Materia Socio Medica, 32(2), 135. https://doi.org/10.5455/msm.2020.32.135-139

Hodge, C. D., Gizlice, Allgood, S. D., Bunton, A. J., Erskine, A., Leeman, J., & Cykert, S. (2022). A hybrid implementation-effectiveness study of a community health worker-delivered intervention to reduce cardiovascular disease risk in a rural, underserved Non-Hispanic Black population: The CHANGE study. American Journal of Health Promotion, 36(6), 948–958. https://doi.org/10.1177/08901171221078272

Statista. (2023). West Virginia: educational attainment of population 2023 | Statista. Statista. https://doi.org/1020000/1024535-blank-355

Thrift, A. G., Ragavan, R. S., Riddell, M. A., Joshi, R., Thankappan, K. R., Chow, C., Oldenburg, B., Mahal, A. S., Kalyanram, K., Kartik, K., Suresh, O., Mini, G. K., Ismail, J., Gamage, D. G., Hasan, A., & Srikanth, V. K. (2020). Hypertension in rural India: The contribution of socioeconomic position. Journal of the American Heart Association, 9(7). https://doi.org/10.1161/jaha.119.014486

WHO. (2023, March 16). Hypertension. Who.int; World Health Organization: WHO. https://www.who.int/news-room/fact-sheets/detail/hypertension/?gad_source=1&gclid=CjwKCAiA9bq6BhAKEiwAH6bqoFpUxvH755SH5xOJ09qPtRTv1_zvRGELKqFc6tcB6rQ5OnkEqOZM2BoCMgYQAvD_BwE